You are on page 1of 10

Matysik 1

Thomas Matysik
Dr. Erin McLaughlin
Multimedia Writing and Rhetoric
24 November 2015
Alternative Medicine: The Implementation of Humor Therapy
In the last 30 years, medical technology has boomed. Between 1980 and 2010, medical
advancements have added five years to the U.S. life expectancy, with dramatic reductions in
fatalities due to heart disease, stroke, and cancer (AdvaMed 1). While the implementation of
these new technologies has extended the lives of Americans, it has also changed the way that
doctors interact with their patients. Doctors now have to spend countless hours being trained in
new technologies in order to keep their Medical Board certification. To compound the problem,
government restrictions and health insurance companies now require piles of charts and billing
forms to be completed each day. Dr. Pauline Chen, a physician and writer for the New York
Times, wrote that as much as a third of an attending physicians workday is spent doing
paperwork, and some resident physicians spend more time documenting than they spend with
patients (Chen 1). With all of these changes, doctors are now spending less and less time with the
patients, caught up in the ceaseless advancement of medical technology and administrative tasks.
Dr. Alexander Golovanov of the University of Manchester suggests that, Doctors have become
so dependent on complex, modern medical techniques that they often neglect to consider
alternative or complementary treatments that could also improve the patients condition.
Alterative medicine has become synonymous with pseudoscience (Golovanov 136). If these
alternative therapies can be used in conjunction with the proven, advanced medical techniques
(complementary), then perhaps the patients condition will improve even more. One alternative

Matysik 2
treatment that has showed promising outcomes is humor therapy, which uses humorous
audio/visuals as a complementary treatment for disease. I believe that humor therapy is an
extremely underused, yet effective treatment for a diverse set of ailments. Further research and
clinical trials should be done on humor therapy, and hospitals should seriously consider utilizing
this approach to treatment.
One of the reasons that I am so interested and personally invested in this topic is because
of my previous experiences interacting with doctors in hospitals. I became interested in the role
of alternative therapies after visiting my grandpa in the oncology wing of the hospital. I
remember the environment being dreary and depressing, and the doctors never really socialized
with any of the patients or their families. I never even met the oncologist who was calling the
shots in my grandpas treatment. The only thing that I knew about my grandpas treatment was
that it was causing him immense pain and even borderline depression. I thought that it would be
better for patient outcomes if there were some kind of social connection between the staff and the
patient, or at least something to keep the patient occupied. About a month later, I shadowed a
physician at Memorial Childrens Hospital of Chicago. In contrast to my grandpas doctors, the
staff there were constantly socializing with the kids, telling jokes and making them laugh. They
brought in clowns or other entertainment on a regular basis. I even saw one kid get his wish
granted by the Make-A-Wish Foundation. The childrens hospital embraced and integrated
humor therapy, not as a replacement for advanced treatments, but as a supplementary treatment.
A doctor told me that the staff truly believes that by treating the patients holistically, the kids
morale stays higher, which leads to better outcomes. Dr. Denise Adams research supports this
when his study, conclude(s) that the use of complementary and alternative medicine by pediatric
hospitals may have an impact on the effectiveness of modern treatments (Adams 227). To me

Matysik 3
this made a lot of sense, but then I started wondering why they dont utilize this in treating adults
as well. Why does such a stark contrast exist between the approach to the treatment of children
and adults? As a pre-med student, I thought it would be interesting and important to find out
whether or not humor affects physical condition. Furthermore, if there is evidence to suggest that
humor therapies can help patients recover, then humor therapy should be implemented at
hospitals across the country.
While it is often written off as pseudoscience, humor therapy has been shown to be
successful in clinical trials, especially for psychological disorders. Dr. Henry Zvi Lothane
suggests that humor therapy is effective in treating psychological disorders because, Humor has
its role in loosening repression, facilitating the emergence of unconscious emotions and ideas,
bringing to light character defenses, and thus driving the process of analysis (232). Zvi goes on
to explain how this fits with Freudian psychoanalytic method, and how humor therapy is an
effective tool that a psychoanalyst can use to expose repressed memory. Zvi concludes his paper
by suggesting that, analyzing jokes and telling jokes is one of the auxiliary techniques of the
psychoanalytic method: it helps to lift repressions, take hold of unconscious emotions and
fantasies, and enhance interpretation (238). If this is true, then humor therapy is a viable
treatment for almost all psychological disorders involving repression, allowing the patient to
expose the root cause of the mental disorder and work through it. In fact, Dr. Robin Haig
examined a case where humor was used by a therapist in the therapy of a young woman with a
borderline personality disorder. Dr. Haig advised that, humor was introduced by the patient
spontaneously and accepted by the therapist, who attempted to utilize it to facilitate treatment
the constructive aspects of her humor in therapy appeared to outweigh the destructive aspects
(552). In this case, the woman tried to use humor as a defense mechanism, which the therapist

Matysik 4
was then able to use to expose the root causes of the borderline personality disorder. She was
then able to work through these issues over time, which essentially cured her of borderline
personality disorder. Her remarkable recovery proves that humor therapy can be effective in
medicine, and is already being used in psychoanalysis.
The same logic can be extended to physical health. If humor and laughter therapy has
been proven to be an effective treatment for some psychological disorders, whats to say that it
isnt also a plausible treatment for some physical disorders? Dr. Helmut Lackner and his
colleagues are renowned Austrian researchers specializing in psychophysiology, cardiovascular
studies, and other related technologies. In their study, they examined the effect of humor
(watching humorous films) on heart rate, blood pressure, and respiration. Based on the statistical
analysis of the study, they concluded that there is some evidence to suggest that humor can
stimulate physiological effects and responses that can improve health, in this case, cardiovascular
health (Lackner 16). If the results of this study are to be trusted, then we can see a direct example
of how laughter and humor could be used as therapy. However, as Dr. Martin described in his
article, more research needs to be done to make definite conclusions, and a single study shouldnt
be used to make a conclusion (219). Another study examined the use of laughter and humor
therapy in dialysis. The article suggests that, therapeutic interventions could range from
humorous videos, stories, clowns, through to raucous simulated laughter and laughter yoga. The
effect of laughter and humor on depression, anxiety, pain, immunity, fatigue, sleep quality,
respiratory function and blood glucose may have applications to the dialysis context and require
further research (Bennett et al 488). These interventions are similar to what I saw at the
childrens hospital, and I believe that they should be implemented on a much more wide scale.
Much of the argument against laughter/humor therapy is that it isnt medicine. While I

Matysik 5
recognize that laughter/humor cant directly cure the disease, it is also important to recognize
that it can play a role in, relieving suffering, reducing pain and anxiety (Bennett et al 491). The
fact that humor therapy cannot cure disease shouldnt hinder its use in hospitals, in fact, many of
the most widely used treatments are meant to treat the disease symptoms, rather than actually
curing the disease. Additionally, humor therapy is intended to be a complementary treatment, so
it should be used in addition to the commonly accepted treatment. Humor therapy has incredible
potential as a complementary treatment, and recent studies support its efficacy. For this reason, I
believe that humor is one of the most effective simple complementary treatments, yet it is almost
never used in a non-pediatric clinical setting.
One of the primary arguments against the use of humor therapy in hospitals is that there
hasnt been enough research done on the subject, or that the studies that have concluded that
humor therapy is effective use faulty methods or incorrect statistical conclusions. Dr. Rod Martin
of the University of Western Ontario suggests that, despite the popularity of the idea that humor
and laughter have significant health benefits, much of the current empirical evidence is generally
weak and statistically inconclusive. More carefully conducted and theoretically informed
research is needed before one can say with certainty that humor or laughter affects physical
health in a positive way (Martin 219). Much of what Dr. Martin is saying is true. Many studies
out there use a small sample size, or may have faulty methodology. However, this does not mean
that every study supporting humor therapy is invalidated. There are well-crafted studies that
support both sides of the argument (such as the Lackner study, the Bennett study, and the Martin
analysis mentioned earlier) and in science, contradictory studies usually leads to more research
being done with more controls and more subjects, making its conclusions more accurate.
However, this has not yet been done for humor therapy, largely because many physicians and

Matysik 6
researchers dont seriously consider it. What I do know is that humor therapy has been very
successful in psychoanalysis, in the treatment of chronic illness in childrens hospitals, and even
in some clinical trials for chronic illness in adults, so the natural next step is to do more research
to determine if humor therapy could work on a larger scale for adult patients with chronic
illnesses.
Another possible argument against humor therapy is that it be too difficult and costly to
implement on a large scale. However, the research may suggest otherwise. Dr. Reem Al-Sudairy,
an oncologist from the King Fahad National Guard Hospital in Saudi Arabia implemented fullscale complementary therapies in the oncology wing of his hospital. While humor therapy was
not one of the complementary therapies included in the study, the cost/benefit analysis of similar
therapies is likely a good predictor for the cost/benefits of instituting humor therapy. Dr. AlSudairy came to the conclusion that, complementary and alternative medicine therapies were
found to be generally inexpensive and simple to implement in a tertiary care center when
compared to more complex modern therapies (194). This isnt surprising considering the
formidable costs of modern technology. For example, the Da Vinci Surgical System, a robot
controlled by a surgeon for minimally invasive surgeries, costs about $2 million plus several
hundred thousand dollars in annual maintenance fees. Additionally, this surgical system requires
extensive training for all hospital staff that uses it. In contrast, humor therapy has no initial cost,
since it isnt a tangible thing. Instead, all that is necessary is to train hospital staff on how to use
humor therapy, and fund the various events or treatment-related resources. The events and
resources are typically inexpensive; some of the treatments used in clinical trials include
humorous movies, audio, comedians, clowns, plays, or even just the hospital staff using a
humorous approach or introducing humorous activities. I would estimate that initiating humor

Matysik 7
therapy for all patients suffering from chronic disease in a medium-sized hospital would cost
between $50,000-$200,000 based on Al-Sudiarys research. Al-Sudiary analyzed the cost of
integrating 5 different complementary therapies into his hospital. He found that the therapies that
he analyzed all required between $50,000 minimum, and $200,000 maximum to fund. For humor
therapy, this would include purchasing humorous films, books, audio, and even live
performances. I believe that humor therapy would fall on the lower end of that range, since many
of the therapies tested in Sudiarys study required hiring and paying a new staff member (ex.
masseuse, acupuncture practitioner, etc.), while humor therapy does not. While this may seem
like a lot of money, it is actually very reasonable compared to the cost of modern medical
technology (see above). In addition, the hospital could regain a lot of this initial investment by
charging patients for the treatment, which would ultimately be paid by their health insurance.
Also, it is important to keep in mind that this therapy could actually save the patient money by
getting the patient out of the hospital faster, since the average cost of a one-day stay in the
hospital is over $1,700 (Sudiary 198). From a cost/benefit standpoint, humor therapy makes
sense to implement on a large scale. It is significantly cheaper to implement than primary
therapies, and may have a huge impact on patient outcomes.
Humor therapy is an extremely underused and underrated complementary treatment that
should be seriously considered for use in the treatment of chronic illness. Studies have shown
that humor therapy is effective, and is now being used in both psychoanalysis and pediatric
oncology. Furthermore, recent research may support that humor therapy can have positive effects
on the patients physical condition for chronic diseases. In a recent guest lecture, Dr. Thomas
Merluzzi of the Harper Cancer Research Institute offered attendees a glimpse at his not-yet
published research. Dr. Merluzzis research indicates that emotional support and instrumental

Matysik 8
support are inversely proportional to psychological distress when the level of emotional support
and instrumental support matches the level of impairment. Merluzzi said that humor therapy
would fall under the emotional support category, since it helps the patient feel included and
improves morale. So if humor therapy is included in the treatment plan, then emotional support
will be increased, ultimately leading to a decrease in psychological distress (Merluzzi). As any
physician can attest, psychological distress interferes with treatment and can have dramatic
effects on patient outcome. Humor therapy has great potential as a complementary treatment, but
modern medicine often unjustly rejects alternative or complementary treatments like humor
therapy. If further research confirms humor therapys effectiveness and humor therapy is
implemented on a large scale as a complementary treatment, I believe that it could completely
change our approach to the treatment of chronic illness.

Matysik 9
Works Cited
Adams, Denise, et al. "Complementary and Alternative Medicine use by Pediatric Specialty
Outpatients. Pediatrics 131.2 (2013): 225-32. Print.
Al Sudairy, R. "Complementary and Alternative Medicine use among Pediatric Oncology
Patients in a Tertiary Care Center, Riyadh, Saudi Arabia." Journal of Clinical Oncology
29.15 (2011) 194-99. Print.
"Assaulting Alternative Medicine: Worthwhile Or Witch Hunt?" BMJ.British Medical Journal
344.feb24 1 (2012): e1393-. Print.
Bennett, Paul N., et al. "Laughter and Humor Therapy in Dialysis." Seminars in Dialysis 27.5
(2014): 388-93. Print.
Chen, Pauline W. "Doctors and Patients, Lost in Paperwork - the New York Times." The New
York Times Apr 8, 2010. Print.
Greene, Lisa. "Bedside Manner is Now a Make-Or-Break Matter. (HEALTH)." The Record
(Bergen County, NJ) (2003): F03. Print.
Haig, Robin A. "Therapeutic Uses of Humor." American Journal of Psychotherapy 40.4 (1986):
543-53. Print.
Lackner, Helmut, et al. "Cardiovascular Effects of Acute Positive Emotional Arousal." Applied
Psychophysiology & Biofeedback 39.1 (2014): 9-18. Print.
Lothane, Zvi. "The Uses of Humor in Life, Neurosis and in Psychotherapy: Part 2."
International Forum of Psychoanalysis 17.4 (2008): 232-9. Print.
Martin, R. A. "Is Laughter the Best Medicine? Humor, Laughter, and Physical Health." Current
Directions in Psychological Science (Wiley-Blackwell) 11.6 (2002): 216-20. Print.

Matysik 10
Medical Technology: The Economic and Health Value to Patients, Advanced Medical
Technology Association. Web. 15 Nov 2015.
Merluzzi, Thomas. How Cancer Patients and Cancer Survivors Find Coping Resources and the
Spiritual Strength to Overcome Their Sickness. University of Notre Dame. Debartolo Hall,
Notre Dame, IN. 18 November 2015. Guest Lecture.
Penson, Richard. Laughter: The Best Medicine? The Oncologist 10.8 (2005): 651-60. Print.
Shorter, Edward. Doctors and their Patients: A Social History. New Brunswick, U.S.A.:
Transaction Publishers, 1991. Print.

You might also like